Factorial validity of the Center for Epidemiologic Studies Depression Scale short form in older population in China

Int Psychogeriatr. 2014 Jan;26(1):49-57. doi: 10.1017/S1041610213001701. Epub 2013 Oct 14.


Background: The objective of this study was to explore the factor structure of a shortened ten-item Center for Epidemiologic Studies Depression Scale (CES-D 10) used in a national survey in China.

Methods: This secondary research is based on the wave I (2011) of the China Health Aging Retirement and Longevity Study (CHARLS). CHARLS recruited a nationally representative community sample of households with members aged 45 years or above. A subsample of 742 respondents aged 60 years and older were used for this study. Confirmatory factor analyses were conducted to test three competing models and determine the best-fit model for the elderly Chinese sample. Factorial invariance across gender was also examined. R2 coefficient was used to measure the reliability of each item.

Results: Confirmatory factor analysis supported the two-factor model as having the best fit. Depressive affect and somatic symptoms were the first factor while positive affect was loaded as the second factor. The multi-group analysis showed that the two-factor structure varied across the male and female groups in China (χ2 (df = 86) = 144.13, p < 0.001). Moreover, gender differences were indicated by individual item reliability scores, mean score, and prevalence rate of depressive symptoms.

Conclusion: The CES-D 10 Scale indicated adequate reliability and validity for the community-dwelling older population in China. In addition, the data revealed that perception and expression of depressive feelings was different between male and female elderly people.

MeSH terms

  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Depression / diagnosis*
  • Depression / epidemiology
  • Depression / psychology
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Psychiatric Status Rating Scales / standards*
  • Reproducibility of Results
  • Sex Factors